H型高血压患者血浆炎性细胞因子水平变化及与颈动脉内膜中层厚度相关性研究

Correlation Between the Changes of Plasma Inflammatory Cytokines Levels and Carotid Intima-media Thickness in Patients With H-type Hypertension

目的探讨H型高血压患者血浆超敏C反应蛋白(hs-CRP)、单核细胞趋化蛋白1(MCP-1)、可溶性血管细胞间黏附分子1(s ICAM-1)、一氧化氮(NO)与6-酮-前列腺素F1α(6-K-PGF1α)水平以及与颈动脉内膜中层厚度(IMT)的相关性。方法选取2012年2月—2013年1月海南省人民医院门诊及住院的原发性高血压病患者167例,根据血浆Hcy水平分为H型高血压组(Hcy≥10.00μmol/L,n=85)和对照组(Hcy<10.00μmol/L,n=82)。两组患者均抽取肘静脉血10 ml,测定hs-CRP、MCP-1、s ICAM-1、NO和6-K-PGF1α水平,并采用经颅多普勒超声测定两组患者颈动脉IMT。结果 H型高血压组Hcy、hs-CRP、MCP-1、s ICAM-1及IMT均高于对照组(P<0.05),6-K-PGF1α和NO均低于对照组(P<0.05)。Pearson相关分析结果显示,H型高血压患者hsCRP、MCP-1、s ICAM-1与IMT呈正相关(P<0.05);NO、6-K-PGF1α与IMT呈负相关(P<0.05)。H型高血压患者hs-CRP、MCP-1、s ICAM-1与NO、6-K-PGF1α均呈负相关(P<0.05)。结论 H型高血压患者存在炎性反应和血管内皮功能障碍,参与动脉粥样硬化形成,并可能导致心脑血管事件发生,应采取措施积极干预。

Objective To evaluate the changes of plasma hs-CRP,MCP-1,s ICAM-1,NO and 6-K-PGF1αand their correlation with IMT in patients with H-type hypertension. Methods 167 cases of outpatients and inpatients with essential hypertension in Hainan Provincial People＇s Hospital between February,2012 and January,2013 were selected as the research subjects who were,according to the plasma Hcy level,divided into the H-type hypertension group（ Hcy ≥10. 00μmol / L,n = 85） and the control group（ Hcy 10. 00 μmol / L,n = 82）. 10 ml elbow vein blood was drawn in both groups to determine the level of plasma hs-CRP,MCP-1,s ICAM-1,NO and 6-K-PGF1α and transcranial doppler was used for carotid intima-media thickness（ IMT）. Results The levels of Hcy,hs-CRP,MCP-1,s ICAM-1 and IMT in H-type hypertension group were all higher than those in the control group and the NO and 6-K-PGF1α levels in H-type hypertension group were lower than those in the control group with significance（ P〈0. 05）. Pearson correlation analysis showed plasma hs-CRP,MCP-1,s ICAM-1 of patients with H-type hypertension were positively related with IMT（ P〈0. 05）,but NO and 6-K-PGF1α were negatively related with IMT（ P〈0. 05）. The plasma hs-CRP, MCP-1, s ICAM-1 were negatively related with NO and 6-K-PGF1α（ P〈0. 05）. Conclusion Patients with H-type hypertension suffer inflammatory reactionand vascular endothelial dysfunction and play an important role in the development of atherosclerosis,which may be correlated to cardiovascular and cerebrovascular events. Positive intervention measures should be taken.